“The elderly have a suicide rate that is twice the rate among youth but make relatively few non-fatal suicide attempts. Greater overall frailty and increased likelihood of physical illnesses contribute to the lethality of suicide attempts in older adults.” — The American Foundation For Suicide Prevention

Years ago, I volunteered at an in-home elder care facility in my neighborhood. It seemed like an ideal way to pass the time as I built my writing career while also doing a bit of good for my neighbors. My own parents were alive, healthy and going strong, and I naively assumed others in their age category would be similarly fit. I anticipated my experience at the facility to look like passing time in pleasant company with the residents of the home.

On my first day, I met a lovely 79-year-old grandmother named 'Ruth.' When I was introduced to her, she smiled politely and nodded her head to me in a regal way as if she were presiding over the head of a long table of generations of family members, rather than wrapped in a faded blue cotton blanket and parked before a talk show on television. She sat erect in her wheelchair with the type of posture that was commonly enforced upon the youth of her generation. She smiled slowly, delicately — like the unfolding of a flower — and spoke just above a whisper. I immediately took a great liking to her gentle and kind spirit.

I spent a lot of time speaking with Ruth about her 60+ year marriage to 'George,' her children and grandchildren. Ruth was very sharp in mind and, in particular, had a great memory for museum pieces in the part of California where we learned we'd once both lived. She was well-traveled and easily discussed the many destinations she had visited with George during their lifetime together. I couldn't help wondering why there was such a powerful undercurrent of sadness just below the rhythm of her words. How, after such a full and exciting life in California, had Ruth ended up alone in an elder-care facility in Texas? Where was her family? And George — what had happened to George?

When I inquired, I learned from the home's director that Ruth and George had made a suicide pact several years before. When a neighbor heard their car's engine running for a long period of time in the closed garage, he became suspicious. He lifted the garage door and found the prone bodies of Ruth and George inside their car.

Ruth was still alive. George was not.

This sounds like a shocking and rare scenario, doesn't it? My subsequent research taught me, however, that it's anything but and similar scenarios are becoming increasingly more commonplace.

According to the Centers for Disease Control and Prevention, approximately 40,000 Americans commit suicide each year. The rate of suicide for those aged 75 and older was 16.3 per 100,000 according to the latest CDC numbers. And men 75 and older took their own lives at a higher rate than any other segment (36 per 100,000).

As Next Avenue has reported, suicide rates are growing among the middle-aged, as well. The most pronounced increases in suicide deaths are among men in their 50s. Their rate of suicide has doubled in the past decade, to about 30 per 100,000. For women, the largest increase was seen in those aged 60 to 64. Their rates increased by nearly 60 percent.

Yet according to the National Institute of Health, the highest risk group of all is older men, with white men age 85 and older having a rate of suicide four times the national average.

The 'why' likely includes anything and everything from economic worries to health concerns to pre-existing mental health conditions.

In our fractured society, our elderly are not often housed with us as they often had been in earlier generations. The loving and watchful eye of concerned family members is not necessarily a part of the daily care of our parents. Ruth and George, for example, were able to create their plan without alerting a single family member; I understand their act came as a huge shock to their children and grandchildren.

In the National Institute of Health's May 2012 newsletter, Dr. David Brent, a psychiatrist at the University of Pittsburgh who studies suicide in families, recommended becoming familiar with the warning signs of suicide. He stressed the importance of getting loved ones into treatment quickly if we become concerned.

“One of the biggest indicators of suicide risk is when somebody begins talking about suicide,” he says. “We used to think that talking about suicide meant you weren’t going to do it, but it’s really the opposite.”

To prevent our elderly loved ones from falling victim to suicide, it's important to know what signs to look for. The warning signs of a possible impending suicide attempt can include:

Years after I met Ruth, I often thought of her and wondered how she was faring. From time to time, I checked in with the home's director to inquire about Ruth's health. I was always told she was 'just fine' and informed there had been 'no changes.'

Considering the passing of time, I'm sure Ruth is gone by now. Her family members never learned why she and George created a suicide pact, and I assume she has taken their reasons to her grave. It's hard not to wonder how she must have felt to have outlived her husband by so many years and to have lost him in such a tragic — and preventable — way.

To learn more about elderly suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). This free, federally-funded service is available to anyone, 24 hours a day, 7 days a week. All calls are confidential.